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Epidemiology of atrial fibrillation among heart failure patients according to ejection fraction.
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1Scientific Research Institute of Cardiology and Internal Diseases - Almaty - Kazakhstan
2RUDN University - Moscow - Russian Federation
3Kazakh National Medical University - Almaty - Kazakhstan
Background:Heart failure is a common syndrome in patients with atrial fibrillation (AF), that particular due to similar risk factors and pathogenesis.
Aim of the study:to evaluate the occurrence of the risk factors depending on left ventricular ejection fraction (LVEF) in patients with AF.
Material and methods:in population-based survey 1544 people with cardiovascular diseases were selected; of them 667 were with AF (56,84%). The association of AF and 3 EF groups was assessed. Patients with thyroid disorders and valvular heart diseases were excluded.
Results:When comparing the 3 EF groups, detection of HFrEF was low and amounted to 16,3%, HFmrEF in 21,5% and the highest number of patients were detected in group with preserved EF, in 62,2%. Despite such distribution, the prevalence of cardiovascular risk factors more often detected in group of patients with reduced EF. Thus, 78,9% of men were with HFrEF versus 57,3% with HFpEF (OR: 2,8; CI 1,7-4,6; p < 0.001), twice as often smoking occurred, 26,6% versus 13,98%, respectively, (OR: 2,23; CI: 1.3-3.7; p < 0.001), 41,3% patients with reduced LVEF suffered a myocardial infarction while in group with preserved LVEF only in 17,6% cases (OR: 0,3;CI: 0,19-0,47; p < 0.001). The frequency of diabetes mellitus (DM) in patients with HFrEF was 27,5%, that exceeded in two times the number of patients (16,1%) in HFpEF group (OR: 1,97; CI: 1,2-3,23; p = 0,011). The incidence of hypertension and prior stroke was similar in both group (p = 0,15 and p = 0,13, respectively).
Conclusion: atrial fibrillation was more common in HFpEF versus in HFmrEF versus in HFrEF. Contrariwise, the significant association of cardiovascular risk factors such as gender, prior myocardial infarction, smoking, diabetes mellitus and atrial fibrillation was detected in group of HFrEF. Importantly, hypertension and prior stroke similarly occurred in patients of all 3 EF groups.
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